Healthcare Provider Details
I. General information
NPI: 1760795561
Provider Name (Legal Business Name): LANCASTER DENTAL ARTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/21/2010
Last Update Date: 04/17/2021
Certification Date: 04/17/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1555 HIGHLANDS DR SUITE 108
LITITZ PA
17543-2800
US
IV. Provider business mailing address
401 COMMERCE DRIVE SUITE 108
FORT WASHINGTON PA
19034
US
V. Phone/Fax
- Phone: 215-550-4590
- Fax:
- Phone: 215-550-4590
- Fax: 215-646-6369
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | DS-029417-L |
| License Number State | PA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
BHASKAR
SAVANI
Title or Position: OWNER
Credential: DMD
Phone: 215-550-4590